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About Central lines....

Nurses   (7,041 Views 12 Comments)
by Sleepyeyes Sleepyeyes (Member)

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Can you think of any meds that cannot EVER be pushed to a central or PICC line?

IVP's to these lines just make me nervous...

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255 Posts; 4,321 Profile Views

Originally posted by Sleepyeyes

Can you think of any meds that cannot EVER be pushed to a central or PICC line?

Nope.

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nursesearl has 30 years experience as a BSN, RN and specializes in Home Care, Urgent Care, ER, Med Surg.

86 Posts; 3,861 Profile Views

Whatever medicines that cannot be "pushed" through a regular IV cannot be pushed through a PICC or central line. For instance, you wouldn't push Vancomycin. Hope this helps.

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pebbles has 17 years experience as a BSN, RN and specializes in Trauma acute surgery, surgical ICU, PACU.

490 Posts; 7,698 Profile Views

Dilantin

it crystalizes in the line and apparently always cloggs it, and should always be given into a peripheral IV line.

(This was posted on our ward recently by one of the IV nurses)

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712 Posts; 5,043 Profile Views

Dilantin doesn't like anything it is a true loner if you have to push that stuff. I dread giving it. I remember taking care of a neonate that had a scalp vein and they were pushing dilantin through it, needless to say that poor baby did suffer a burn. I don't know why didn't they found a much better site than the head.

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RNforLongTime specializes in Med-Surg Nursing.

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Potassium Chloride! DONT EVER EVER EVER PUSH KCL into any IV! The hep flush bottles and KCL bottles look alike! This is why we don't stock KCL on the floors anymore and there are a lot more pre-mixed KCL IV's.

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61 Posts; 2,549 Profile Views

Dilantin can only be given into NS. It should always go into a central line if that is present. I have seen a patient lose a hand from a peripheral IVP of dilantin into an infiltrated IV. You must have a large bore needle and a good IV. Our policy is that the IV must be above the wrist--written of course after the above incident. I would never give it peripherally if a central line is present.

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219 Posts; 3,777 Profile Views

In general, if it can be given IV, it can be given in a central line. If it can be pushed, it can be pushed through a central line. Both dilantin and KCl need to be diluted and given over relatively long periods of time. I can't think of a single medicine that is not better tolerated via the central route over the peripheral. Gary

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caroladybelle is a BSN, RN and specializes in Oncology/Haemetology/HIV.

5,486 Posts; 29,614 Profile Views

Hospitals are still using Dilantin!!!!!! Please get the Pharm.D to switch to Cerebyx stat!!!!! A Dilantin drug bound with a phosphate group (thus the name Fosphenytoin) does not cause pain on injection, does not damage veins, is compatible with lots of solutions, can be given much quicker (useful in acute seizures), and is basically the same as Dilantin in most therapeutic respects.

It is expensive (new drug) but if you figure in lawsuit costs (damage from Dilantin problems) it might convince your suits to switch. My current hospital as well as Dilantin's manufacturer are trying to switch over to the safer drug.

As far as drugs that cannot be given by central lines/ports/PICCs, many radiologic drugs should not be given per central access, as they must be pushed so rapidly/under high pressure - that it is not appropriate to give via some central accesses. Facilities should have a policy on this.

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1,244 Posts; 8,840 Profile Views

Thanks, all! I've learned something from each of you and I appreciate it!! :kiss

I'm new to a tele floor--just hung my first cardizem drip the other day, and had to push Lopressor on another pt. While standing there (forever, it seemed) it got me thinking of this question.

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pebbles has 17 years experience as a BSN, RN and specializes in Trauma acute surgery, surgical ICU, PACU.

490 Posts; 7,698 Profile Views

Originally posted by caroladybelle

It is expensive (new drug) but if you figure in lawsuit costs (damage from Dilantin problems) it might convince your suits to switch. My current hospital as well as Dilantin's manufacturer are trying to switch over to the safer drug.

lol.... man, I wonder how many differences there will be once I get to the states. I live in canada - this snazzy new drug would never cut it in publicly funded health care - the government is already up in arms over high drug costs. Nobody seems to give a sh*t about lawsuits here... :rolleyes:

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